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NPI Code Detail

MEDICARE: DR. INNA GORDIN M.D.

MEDICARE:  DR. INNA  GORDIN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician113620583NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093866386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. INNA GORDIN M.D.
Provider Business Mailing Address
First Line : 1664 E 14TH ST STE 302
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1167
Country : US
Telephone Number : 718-382-0500
Fax Number : 718-382-7025
Provider Business Practice Location Address
First Line : 1664 E 14TH ST STE 302
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1167
Country : US
Telephone Number : 718-382-0500
Fax Number : 718-382-7025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 07/08/2007

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